Studies: Surgeons could save lives, $20B by using checklist

According to a study released online in the New England Journal of Medicine, a study of eight hospitals around the world showed that hospitals can reduce the number of deaths from surgery by more than 40% and trimmed the number of complications from 36% by using a checklist that helps doctors and nurses avoid errors.


If all hospitals used the same checklist, they could save tens of thousands of lives and $20 billion in medical costs each year, says author Atul Gawande, a surgeon and associate professor at the Harvard School of Public Health. According to the USA Today article (, the 19-point checklist has nothing to do with high technology, Gawande says. Instead, it focuses on basic safety measures, such as ensuring that patients get antibiotics to prevent infection and requiring that all members of the team introduce themselves.

In the study (, released online for free, which was funded by the World Health Organization, hospitals reduced their rate of death after surgery from 1.5% to 0.8%. They also trimmed the number of complications from 11% to 7%. The study shows that an operation's success depends far more on teamwork and clear communication than the brilliance of individual doctors, says co-author Alex Haynes, also of Harvard. And that's good news, he says, because it means hospitals everywhere can improve. Researchers modeled the checklist, which takes only two minutes to go through, after ones used by the aviation industry, which has dramatically reduced the number of crashes in recent years.

Safety organizations around the world have pledged to get hospitals on board. Four countries the United Kingdom, Ireland, Jordan and the Philippines already have plans to use the checklist in all operations.

It usually takes 17 years for medical advances to become standard practice, says Joe McCannon, vice president of the Institute for Healthcare Improvement, which works with 4,000 American hospitals on improving quality. He wants the country to move much faster this time by having all U.S. hospitals try the checklist by April 1. "Patients deserve it, and they deserve it now," McCannon says.



(Sources: New England Journal of Medicine,, accessed January 15, 2009; USA Today,, January 14, 2009)